| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3944557 | Gynecologic Oncology | 2014 | 5 Pages |
•Tumors with ≤ 2.0 cm represent significant lower frequency of pelvic lymph node involvement as tumor 2.1–4.0 cm (13.3% vs. 23.4%; p < 0.001).•Large tumors were accompanied by an increase of recurrent disease (18.8% vs. 6.7%; p < 0.001).•The 5-year overall survival rate was significantly reduced with larger tumor size (85.1% vs. 94.0%).
ObjectivesLimited knowledge exists about the value of tumor size in surgically treated cervical cancer (CX) using a tumor size of 2 cm as cut-off value.MethodsA total of 366 cases of CX FIGO stage IB who received upfront surgery were evaluated regarding tumor size, the prediction of pelvic lymph node involvement, and recurrence-free and overall survival during a median follow-up time of 94 months. Tumors ≤ 2.0 cm were defined as small, tumors 2.1–4.0 cm as medium sized and those larger than 4 cm as bulky disease.ResultsSmall tumors were seen in 28.7%, medium sized in 52.5% and bulky tumors in 18.9%. There was a significant higher frequency of pelvic lymph node involvement with increasing tumor size (13.3% vs. 23.4% vs. 43.5%, respectively; p < 0.001) and an increase of recurrent disease (6.7% vs. 18.8% vs. 29.4%, respectively; p < 0.001). The 5-year overall survival rate was significantly reduced with increasing tumor size (94.0% vs. 85.1% vs. 69.9%, respectively; p < 0.001).Pelvic lymph node involvement and maximal tumor size were independent prognostic factors for both recurrence-free and overall survival in multivariate analysis.ConclusionsThe results support that tumor size is of prognostic impact in FIGO stage IB cervical carcinomas. A further substaging is suggested for tumors up to 4.0 cm maximum dimension using a cut-off value of 2.0 cm as discriminator. Patients with tumors ≤ 2.0 cm may represent low risk disease.
